Introduction
The aim of surgery is to reattach the torn tendon end to bone. Surgery should be undertaken in the first 2-4 weeks. After that, repair becomes more difficult as the tendon retracts further and risks of surgery increase.
Indications
Surgery is recommended for:
- Active individuals.
- Workers requiring repetitive elbow use / strength.
- Athletes.
- Those concerned about cosmetic appearance.
Procedure
The surgery is under general anaesthesia and is performed as day only in hospital. Through a small incision at the front of the elbow, the torn tendon end is identified and reattached (if reparable) to the bone using drill holes and a toggle button which is passed through to the other side of the bone to maintain the attachment.
The arm is placed in a sling post operatively to protect the tendon reattachment.
Recovery
After surgery, sling is used for comfort only. Once can start gentle elbow / hand / finger movement immediately after surgery.
The tendon takes 3 months to heal and fully attach to the bone. Light duties / office work can begin immediately after surgery. Lifting is limited in the first 6 weeks.
Sports and manual labour using the affected arm can begin at approximately 3 months post-surgery.
Results
The muscle shape is returned to normal. Patients regain strength and normal function at approximately 3-4month post-surgery.
Risks and complications
These include:
- Re-rupture of tendon.
- Pins and needles / numbness in the forearm due to stretch of nerves during surgery.
- Fracture of the bone.
- Permanent nerve damage <1%.
- Infection.